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Chapter 14 - Encephalopathy

from Part II - Case-Based Approach to Specific Conditions

Published online by Cambridge University Press:  22 February 2024

Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Kyle C. Rossi
Affiliation:
University of Massachusetts Medical School
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Summary

This chapter uses a case-based approach to describe electrographic patterns associated with encephalopathy. Global cerebral dysfunction (encephalopathy) is typically characterized by a “low and slow” record that is not specific to any particular etiology. Severe forms show background discontinuity, absence of a posterior dominant rhythm, and loss of reactivity. Generalized rhythmic delta activity (GRDA) and generalized periodic discharges (GPDs) with triphasic morphology (triphasic waves) are two common patterns seen in encephalopathic patients. As with other rhythmic and/or periodic patterns, it is important to recognize that these patterns may lie on an ictal–interictal injury continuum (IIIC) and may need appropriate management. Cyclical alternating pattern of encephalopathy (CAPE) is a pattern of spontaneously alternating background changes that may have prognostic implications.

Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
, pp. 191 - 203
Publisher: Cambridge University Press
Print publication year: 2024

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References

Hooshmand, H. The clinical significance of frontal intermittent rhythmic delta activity (FIRDA). Clinical Electroencephalography. 1983 Jul;14(3):135–7.Google Scholar
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O’Rourke, D, Chen, PM, Gaspard, N, et al. Response rates to anticonvulsant trials in patients with triphasic-wave EEG patterns of uncertain significance. Neurocritical Care. 2016 Apr;24(2):233–9.Google Scholar
Hirsch, LJ, Fong, MW, Leitinger, M, et al. American Clinical Neurophysiology Society’s Standardized Critical Care EEG Terminology: 2021 version. Journal of Clinical Neurophysiology. 2021 Jan 1;38(1):1.Google Scholar
Kassab, MY, Farooq, MU, Diaz-Arrastia, R, Van Ness, PC. The clinical significance of EEG cyclic alternating pattern during coma. Journal of Clinical Neurophysiology. 2007 Dec 1;24(6):425–8.Google Scholar

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  • Encephalopathy
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.017
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  • Encephalopathy
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.017
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Encephalopathy
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.017
Available formats
×